SUBSTANCE ABUSE IN WOMEN OF REPRODUCTIVE AGE GROUP IN THE GENERAL OUTPATIENTS CLINIC, UCH IBADAN

Abstract

Substance abuse is a national public health problem; the implication and the societal burden
are worrisome especially in women of child bearing age. Studies on substances use disorders
on women are few worldwide. The objective of this study was to identify commonly abuse
substance, level of awareness, the clinical and psychosocial factors associated with substance
abuse in women of reproductive age. A cross sectional survey was carried out at General
Outpatient Clinic of the University College Hospital, Ibadan.
A total of 592 women were interviewed, of this 50.3% were married, 76.2% belonged to
monogamous, 65.7% lived in the transitional area of Ibadan, over 90% had at least primary
education and about 64% were employed. Respondents were mostly from the South West
zone of Nigeria (82.3%).
Majority of the respondents had heard of all the licit substances. Among these substances,
caffeine was the most commonly used (88.5%), others were alcohol 32.5%, hypnosedatives
27% and tobacco 2.3%. 30% of women taking caffeinated beverages were not aware of any
harmful effect it had on health.
Some social variables such as family violence, multiple sexual partners, first coitus and poor
control of relationship were significant associated with the use of the licit substances
(especially alcohol and hypnosedative) (p<0.05). Usually a related family member also used
these substances.
Substances were first introduced to the user- as a child (age ≤12) in 56% and by the family in
79.5%, the main source was from petty trader (66.2%) and the most used substance by the
family members was caffeine (60 – 84.1%). Despite the level of awareness of the harmful
effect, 59.2% of the respondents were still enjoying the use of substance. 65.4% felt the use
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was right and 39.9 % of the users was on substance during pregnancy, of this only 40.2 %(
51/127) attempted to cut it down.
The risk of overweight was over 50% in those who used alcohol, hypnosedatives and caffeine.
The risk of systolic and diastolic hypertension; for tobacco use were 50% and 28%; for
caffeine use were 22% and 18% respectively. Alcohol on the other hand showed beneficial
effect of 15% for systolic and 26% for diastolic hypertension. Whilst hypnosedative also
revealed beneficial effect of 50% for systolic and 16% for diastolic hypertension. Though the
proportions of the user of illicit drugs were very low, marijuana was the most commonly
abused 1.4% (8/592). Over 80% of all the respondents were aware of the harmful effect of
marijuana, heroine and cocaine. Hallucinogen, amphetamines and solvents were not well
known amongst the respondents and therefore the awareness of the harmful effects to health
was low.
In conclusion, this study has revealed to us that caffeine, alcohol and hypnosedative abuse
are assuming a significant dimension as indicated by the prevalence and the association with
some demographic features, family influence, psychosocial and clinical problems. Despite
the high level of awareness of the harmful effect of all the substances, a significant proportion
of the respondents was getting addicted to some especially the licit drugs. Other substances
in this study were not significant as their prevalence were very low.
There is a need to call all stakeholders including the government, community, health care
givers (Family Physician, Obstetrician & Gynaecologists etc.) and the managers of health
care for immediate and enduring measures to curb the trend now to avert the future medical
and socioeconomic consequences to the family and the unborn children.

SUBSTANCE ABUSE IN WOMEN OF REPRODUCTIVE AGE GROUP IN THE GENERAL OUTPATIENTS CLINIC, UCH IBADAN